International
Pharmaceutical Federation (FIP), a
global federation representing three million pharmacists and pharmaceutical
scientists worldwide, in its 2009 Council meeting held at Istanbul, Turkey
decided to observe ‘World Pharmacists Day’ annually on September 25, the day when
FIP was founded in the year 1912. Main objective of the World Pharmacist Day
campaign is to raise awareness about the professional activities of a qualified
pharmacist and educate the public on the invaluable role and crucial
responsibilities of the qualified pharmacists in healthcare system and also to
inculcate a sense of pride, solidarity and awareness among the pharmacy
professionals on a global level. Given the fact that pharmacists represent the third
largest healthcare professional group in the world and India too is home to
over ten lakh registered pharmacists, Pharmacy Council of India has also
decided to celebrate Pharmacist’s Day from this year onwards.
Over the past few decades there has been a trend for
pharmacy profession to move away from its original focus on medicine supply
towards a more inclusive focus on patient care. The role of the pharmacist has
evolved from that of a compounder and supplier of pharmaceutical products
towards that of a provider of services and information and ultimately that of a
provider of patient care. Number of medication options have also multiplied
manifold thus raising the complexity of therapies. Pharmacists have a unique
role to play in evaluating these options and utilize their knowledge and skills
to prevent, detect, monitor and resolve any medicine related problems. The
concept of the seven-star pharmacist, introduced by WHO and taken up by FIP in
2000 in its policy statement on Good Pharmacy Practice, sees the pharmacist as
a caregiver, communicator, decision-maker, teacher, life-long learner, leader
and manager. However the involvement of qualified pharmacists
in J&K state in this regard has remained abysmally low, contrary to
trends in other Indian states and developed countries. While seeking medical
help, people think of a doctor or a nurse or a medical assistant, but seldom
does a pharmacist come to mind probably because even a matriculate is eligible to
be registered as a pharmacist in this state and anybody can get a license to
sell medicines irrespective of his educational and technical background. Amidst
all the mess prevailing in our state, people holding degrees in Pharmaceutical
Sciences are jobless and have been left to lurch to fend for themselves. All this
needs correction by introducing professional services of Clinical Pharmacy
alongwith a novel concept of “Pharmaceutical Care”.
Pharmaceutical Care is a patient-centered,
outcome-oriented pharmacy practice that requires the qualified pharmacist to
work in concert with the patient and the patient's other healthcare providers
to promote health, to prevent disease and to make sure that drug therapy
regimens are safe and effective. Professional Clinical Pharmacy services
offered by trained personnel holding graduate and post-graduate degrees in
Pharmaceutical Sciences can help a great deal in identifying potential and
actual drug-related problems; addressing needs and resolving actual drug
related problems; preventing potential drug-related problems and optimizing
patient therapy outcomes. It is a
practice in which the pharmacy practitioner assures that all of a patient's
drug therapy is used appropriately for each medical condition; the most
effective drug therapy available is used; the safest drug therapy possible is
used, and the patient is able and willing to take the medication as intended. Patients
in our part of the globe have not been able to avail such professional
pharmaceutical care services so far as a result of which there is large scale
dissatisfaction and disillusionment among them since they largely remain uninformed
about various lab investigations conducted upon them and about the necessity
for various drug therapies prescribed.
Clinical Pharmacy on the whole is in its
infancy in the state of Jammu and Kashmir and the concept of Pharmaceutical
Care is completely new to most of the physicians, nurses and even pharmacists
presently working at the government health facilities. As a result of the
patient overload of physicians and some other reasons, they are not in a
position to offer detailed counseling, patient education and pharmaceutical
care services on individual basis to all their patients. Therefore it is for
the trained pharmacy practitioners to step in and fill the void by offering
such services with a view to achieve definite therapeutic outcomes that improve
a patient’s quality of life. Overall goal of professional Clinical Pharmacy
services is to optimize the therapeutic outcome management and decrease the
burden of five D’s viz, death, disease, disability, discomfort and
dissatisfaction among patients. Clinical, economic and humanistic outcomes will
also shift towards the positive side as a result of these integrated and
seamless healthcare services rendered by a trained pharmacy practitioner. With
these aims and objectives, University of Kashmir started a post-graduate
programme in Pharmacy Practice four years back at its Department of
Pharmaceutical Sciences. The course includes a mandatory practical internship training
for one year in a hospital besides a year-long research work in hospital,
clinical or community pharmacy that culminates with compilation and submission
of a dissertation.
Overall scenario in relation to professional
pharmacy services in the entire state of J&K is very dismal where we have
mostly unqualified people working as pharmacists in retail pharmacies and
dispensing medicines to patients without any technical know-how about the same
and without providing any basic information to the patients about the use and
possible side-effects of medicines. In government sector too, pharmacies within
hospitals, primary health centres and sub-centres are manned by Medical
Assistants who have not undergone any formal training as required under norms,
specifically in pharmacy. We don’t have any positions available for pharmacy
graduates and post-graduates at any level in our government sector. In fact
their applications are not accepted for Junior Pharmacist posts advertised by
the Directorate of Health and Family Welfare on the pretext of being
‘over-qualified’ for the job. Consequently the services of qualified
pharmacists remain completely unutilized in the state, depriving patients of
precious information about the use of drugs. Every major hospital in our state
needs to have a full-fledged Department of Pharmacy Practice with adequate
infrastructure, manpower, equipments and funding. Since that is already well
stipulated in the approved drug policy of our state, government needs to start
working in that direction in its right earnest.
Need of the hour is to design, implement and
monitor policies aimed at providing professional Clinical Pharmacy services to the
patients at primary, secondary and tertiary care level so that the services of
pharmacy graduates and post-graduates can be availed at every level of our
healthcare system for the greater benefit of the patients at large. Such
services will also pave way for the engagement of trained and qualified
pharmacists in providing patient education and counseling services, monitoring
drug therapy and suggesting interventions wherever required, reporting any
adverse drug reactions and drug interactions, supplying drug information to
physicians and nurses, conducting drug-utilization evaluation studies, assist
in framing policies, preparing monographs and hospital formularies and in
providing poison control services. Trained and qualified pharmacy practitioners
should be a part and parcel of the medical team during ward rounds and their
assistance must be sought in prescribing best possible drug therapy to the
patients. It is time to keep pace with fast changing times and trends and
establish clinical pharmacy as a full-fledged profession in the state, ultimate
aim of which is to optimize the clinical outcomes of drug therapy and thereby
improve patient’s health-related quality of life.
(Author teaches at the Department of
Pharmaceutical Sciences, University of Kashmir and is incharge of Masters Degree Programme in Pharmacy Practice. He can be reached at
ishaqgeer@gmail.com)
